Die Therapie der Frühphase des idiopathischen Parkinson-Syndroms

Zusammenfassung

Durch eine gute, adäquate Therapie in der Frühphase lassen sich die motorischen Symptome des Parkinson-Syndroms über viele Jahre gut behandeln, und die Prognose wird deutlich verbessert. Eine für alle Patienten verbindliche Therapie gibt es nicht, vielmehr ist ein individuelles Vorgehen angezeigt, bei dem vor allem das Alter des Patienten und die Kardinalsymptome berücksichtigt werden. In der Frühphase wird man versuchen, den Einsatz von L-Dopa hinauszuzögern und, falls notwendig, die L-Dopa-Dosis gering zu halten. Bevorzugt werden Dopaminagonisten eingesetzt, die durch Amantadin oder MAO-Hemmer ergänzt werden können. Bei unzureichendem Effekt auf den Tremor kann Budipin Einsatz finden.

Aktuelle Entwicklungen zielen neben einer pharmakologischen Überlegenheit gegenüber herkömmlichen Präparaten vor allem auf eine neuroprotektive Therapie.

Summary

Motor symptoms of Parkinson’s disease can be managed for many years by good and adequate treatment in the early stage, and prognosis is significantly improved. There is no therapeutic regimen that would apply to all patients but only individual approaches with primary focus on the patient’s age and the cardinal symptoms. Application of L-dopa is delayed as much as possible in the early stage. If inevitable, we try to keep the dose of L-dopa low, giving preference to dopamine agonists, perhaps supplemented by amantadine and MAO inhibitors. Budipine may be used in case of inadequate effect on tremor.

Current developments aim at pharmacologic superiority and particularly at neuroprotective therapy.

Schlüsselwörter

Morbus Parkinson - Therapie - Frühphase - Physiotherapie - L-Dopa - Dopaminagonisten

Keywords

Parkinson’s disease - therapy at onset - physiotherapy - L-Dopa - dopamine agonists

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